子宫肌瘤剔除术后血清ADAMTS1/9表达及与预后相关性

Serum A disintegrin and metalloproteinase with thrombospondin motif's 1(ADAMTS1)and ADAMTS9 expressions of pa-tients after uterine myomectomy and its correlation with the prognosis

目的:探讨子宫肌瘤剔除术后患者血清含血小板结合蛋白基序的解聚蛋白样金属蛋白酶1(ADAMTS1)、ADAMTS9的表达及与术后预后关系。方法:选择2019年3月-2020年10月在雍森医院行子宫肌瘤剔除术患者137例为观察组,同期健康体检子宫正常者137例为对照组,酶联免疫吸附法检测观察组术后7d血清ADAMTS1、ADAMTS9水平;术后随访1年,分为复发组28例及未复发组109例;logistic回归分析影响术后复发的危险因素,受术者工作特征曲线(ROC)分析术后血清ADAMTS1、ADAMTS9水平对术后肌瘤复发的预测价值。结果:血清ADAMTS1、ADAMTS9水平,术前观察组高于对照组,术后观察组均低于术前且未复发组低于复发组(均P<0.05);术后血清ADAMTS1、ADAMTS9水平是术后肌瘤复发的危险因素(P<0.05),其水平诊断肌瘤复发的曲线下面积(AUC)分别为0.796(95%CI 0.710~0.882)、0.791(95%CI 0.693~0.889),二者联合检测的AUC为0.920(95%CI 0.873~0.967),此时的敏感度89.3%,特异性84.4%。结论:子宫肌瘤患者血清ADAMTS1、ADAMTS9水平异常,且增高为复发危险因素,二者联合检测可为术后肌瘤复发提供参考。

Objective: To investigate the expressions of serum A disintegrin and metalloproteinase with thrombospondin motifs 1(ADAMTS1)and ADAMTS9 of patients after uterine myomectomy, and to study the correlation between the ADAMTS1 and ADAMTS9 levels of the patients and their prognosis after uterine myomectomy. Methods: 137 patients who had undergone uterine myomectomy from March 2019 to October 2020 were selected in research group, and 137 patients with normal uterus who had accepted the healthy physical examination were selected in control group during the same period. Enzyme-linked immunosorbent assay was used to detect the levels of serum ADAMTS1 and ADAMTS9 of the patients on the 7 th day after operation. The patients were followed up for 1 year, 28 cases with the recurrence of myoma of uterus were in group A and 109 cases without the recurrence of myoma of uterus were in group B. Logistic regression was used to analyze the risk factors affecting the postoperative recurrence of myoma of uterus. Receiver operating characteristic(ROC)curve was used to analyze the values of the postoperative levels of serum ADAMTS1 and ADAMTS9 for predicting the postoperative recurrence of myoma of uterus. Results: The levels of serum ADAMTS1 and ADAMTS9 of the patients in the research group before operation were significantly higher than those of the patients in the control group, but which of the patients in the research group after operation were significantly lower than those of the patients in the control group, and which of the patients in group B were significantly lower than those of the patients in group A(all P<0.05). The levels of ADAMTS1 and ADAMTS9 of the patients in the research group after operation were the risk factors of postoperative recurrence of myoma of uterus(P<0.05),and the area under the curve(AUC)of the ADAMTS1level and ADAMTS9level of the patients for diagnosing their myoma recurrence were 0.796(95%CI 0.710-0.882)and 0.791(95%CI 0.693-0.889),respectively.The AUC,the sensitivity,and the specificity of the combined levels of ADAMTS1and ADAMTS9of the patients for diagnosing their myoma recurrence were 0.920(95%CI 0.873-0.967),89.3%,and 84.4%,respectively.Conclusion:The levels of serum ADAMTS1and ADAMTS9of the patients with myoma of uterus are abnormal,and the increased levels of which are the risk factor of myoma recurrence,and the combined levels of serum ADAMTS1and ADAMTS9can provide reference for predicting the postoperative myoma recurrence.